Humans and chimpanzees diverged about 6 million years ago, after which chimpanzees remain in tropical rain forests in Africa, while humans have expanded world over and developed civilizations. The main reason for our success is the fact that we have culture which we can share, develop, and transmit to the next generation. Then, what are the biological bases for having culture? Part of them is the "theory of mind" function in the brain, and the triadic representation which underlies the sharing of ideas between people about the world outside. Culture is a collective activity. In order to have culture, it is not enough for an individual to have high cognitive abilities and potential for innovation, but also the ability to understand other people's mind and share the ideas together. Cooperation is the core of human culture and language is a means of communication built on the ability of triadic representations. Human childhood is unique because children cannot feed themselves for a long time after they are weaned. In most of the mammalian species, including the chimpanzee, individuals feed themselves after weaning. Humans have a large brain which enables an adult to use complex techniques for their subsistence. Substantial amount of care, support, protection and teaching is needed before a child becomes a functional adult, and this cannot be provided by parents only. We, humans, are communal breeder. Social intelligence, not just for competitive situation but also for cooperative situation, has made humans quite unique among animals on the earth.

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Caloric restriction (CR) has been applied as a powerful tool in aging research. CR is accepted as a robust, reproducible and simple experimental manipulation known to extend both median and maximum lifespans, and to retard and suppress a broad spectrum of pathophysiological changes in a variety of mammals. In general, CR delays skeletal and sexual maturation, reduces body size with less adiposity, lowers body temperature, modulates hyperglycemia and insulinemia, alters lipid and energy metabolisms, protects against internal oxidative and environmental stresses, and activates mitochondrial biogenesis and sirtuins. Based on the adaptive response hypothesis against food shortage, I propose that CR promotes adipose tissue remodeling and modulates energy metabolism via sterol regulatory element binding protein (SREBP) 1c, a master transcriptional factor of fatty acid biosynthesis. Activation of de novo fatty acid biosynthesis regulated by SREBP1c might play an important role in the anti-aging and lifespan extension by caloric restriction.

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Anorexia nervosa (AN) is a disease that is caused by and persists due to a number of factors, including heredity, personal factors, and social circumstances. The change of many biologic indicators is caused as a secondary phenomenon by undernutrition. These changes can influence appetite and brain function. In this paper, genetic and biological indicators (biomarkers) associated with the symptoms of AN are summarized. 1) Psychic symptoms such as mood and anxiety : Changes in 5-HT (serotonin) activity, abnormality of the 5-HT gene receptor and BDNF (brain-derived neurotrophic factor). 2) Reward system : Abnormalities of cannabinoid receptor genes and dopamine related proteins and polymorphism of COMT (Catechol-0-methyltransferase). 3) Appetite control system : The effects of eating-related peptides complicated as a result of chronic starvation. Our data shows that the BMI values of chronic AN patients had a negative relation to "maturity fear" on psychological test and to desacyl ghrelin but not active ghrelin. Timing was different between nutritional improvement and the change of eating-related peptides during the recovery process of AN. 4) Metabolism and body composition : Dysfunction of beta-adrenergic receptors and UCP (uncoupling protein) as agents facilitating weight loss were noted. We reported that the body consumes fat mainly as an energy source under conditions of starvation at a BMI level of 13 kg/m^2 or more and that the supply of energy is converted from fat mass to FFA (fat free mass) at a BMI lower than 13 kg/m^2. We also report that the risk of urgent hospitalization due to physical factors increases as the BMI value and FFA volume decreases. Furthermore, for patients in a severely emaciated state of AN (<12.5kg/m^2), we found that FFA was predominantly synthesized and that BMR (basal metabolic rate) was inhibited during the period of increasing weight. The physical management is important to the improvement of the FFA, which is critical for patients at this stage.

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Eating disorder is one of the intractable diseases, and the pathology is incompletely understood. Comparing to other organic illness, an appropriate animal disease model is non-existent. For that reason, there is an obstacle to elucidate the pathogenesis of eating disorder and the development of its treatment due to the difficulty in extrapolating the results of animal experiment to human beings. At present, the pathogenesis of eating disorder is considered to be a complex of abnormalities at the whole-body level with environmental and genetic factors, such as 1) cognition in the upper central nervous system, 2) feeding regulation in the hypothalamus that peptides play a pivotal role, 3) sensibility of feeding-regulatory peptide receptors, 4) feeding-regulatory signal transduction pathway from periphery, and 5) the level of feeding-regulatory signal from periphery that peptides play a pivotal role. Abnormalities in blood concentration of feeding-regulatory peptides have been reported in eating disorder. We present the current states and the future possibilities of researches focused on peripheral feeding-regulatory peptides regarding elucidation of the pathology of eating disorder, especially anorexia nervosa, and the development of its treatment.

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Neuroimaging studies on Eating disorder patients have been done recent years. We evaluated histamine H1 receptor binding potential in female patients with anorexia nervosa (AN), healthy men and women. Healthy women showed higher binding potential in bilateral orbitofrontal cortices, right temporal cortex, bilateral amygdalas, and bilateral hippocampi than men. AN showed higher binding potential in right amygdala and left lentiform nucleus than healthy women. These differences may be relevant to pathogenesis and maintenance of AN. We administered the Wisconsin Card Sorting Test to AN and healthy women, and recorded brain blood flow change during the task with fMRI. AN showed poorer brain activity in right ventrolateral prefrontal cortex and bilateral parahippocampal gyri than healthy women. Ventrolateral prefrontal cortex is activated during judgement. Parahippocampal gyri play a role in prediction of future events. ANs' judgement and prediction may be impaired. Neuroimaging studies of eating disorder will make a breakthrough to elucidation of the disease.

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Introduction : We conducted a study on patients with depressive tendencies who are overshadowed by patients with depression and may be overlooked by physicians in psychological treatment. These patients account for approximately 40% of the entire inpatients with vertigo and should not be overlooked in treatment. Objective and Methods : Investigation was conducted to clarify the details of Quality of Life (QOL) (Physical Component Summary [PCS] and Mental Component Summary [MCS]) improvement by the combination therapy of group vestibular rehabilitation and a therapeutic agent for vertigo, Hochuekkito. The patients underwent Self-rated Depression Scales (SDS) test before the hospital treatment and those with SDS scores of 40 or more and below 50 were included in the study. Vertiginous and psychological symptoms at four weeks after the hospital discharge were assessed in the group treated with the combined therapy of group vestibular rehabilitation with a therapeutic agent for vertigo, Hochuekkito and in the group without the administration of Hochuekkito, in order to clarify the overall therapeutic effect and the optimal treatment for vertigo according to the patient's condition. Results and Conclusion : The combined therapy of group vestibular rehabilitation with therapeutic agent for vertigo, Hochuekkito was effective in improvement of results of psychological assessments, such as SDS, QOL test (MCS), State-Trait Anxiety Inventory (STAI) (specific anxiety), Profile of Mood States (POMS) (Anger-Hostility [A-1-1] and Total Mood Disturbance [TMD]) and showed superior improvements compared to the group without administration of Hochuekkito. Based on the improvement of QOL test (MCS) and POMS (A-H and TMD), administration of Hochuekkito 3.75 g twice daily was considered to have a sufficiently improved psychological function in patients with depressive tendencies.

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Social Anxiety Disorder (SAD) is known as the most common type of Anxiety Disorder. In recent studies, it was suggested the cost and probability bias is considered to be a maintaining factor of SAD symptoms. Especially, previous research revealed that the reduction of cost bias was highly related to the improvement of SAD symptoms. In SAD, previous studies also suggested that depressive symptoms often occur secondarily. It was also reported that depressed patients held irrational belief and it could lead to their negative mood. However, the difference of correlationship among cost bias, irrational belief, and SAD symptoms has not been understood in detail. In this study, the purpose was to examine the difference of correlationship among cost bias, irrational belief, and social anxiety. Undergraduate students (n=201) completed a set of questionnaires : the Social Cost/Probability scale (SCOP) ; the Short Fear of Negative Evaluation scale (SFNE) ; the Liebowitz Social Anxiety Scale (LSAS); the Japanese Irrational Belief Test (JIBT) ; and the Self-Rated Depression Scale(SDS). First, correlation analysis revealed that there was a moderate positive correlationship among each measure. Second, partial correlation coefficients among each measure by controlling JIBT were calculated. The results indicated that cost bias related to social anxiety independently. Third, partial correlation coefficients between each measure by controlling SCOP indicated that there was a weak relationship between irrational belief and social anxiety. These results indicated that cost bias which is the specific cognitive bias in social anxiety is strongly rerated to SAD symptoms. On the other hand, it was a suggested that there was a spurious correlation between irrational belief and social anxiety. Based on these findings, the importance to assess and improve the specific cognitive bias in SAD was indicated.

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Background & aim : Patients with medically unexplained symptoms are referred to psychosomatic medicine as mental or functional gastrointestinal disorders. However, we often experience the cases in which the diagnoses turn out to be malignancy. The aim of this study is to clarify the factors in overlooking malignancy. Method: Among patients who were referred to the department of psychosomatic medicine in Tohoku University Hospital from January 2000 to December 2009, we searched patients whose clinical symptoms were caused by malignancy and analyzed the reasons for overlook. Result: There were nine cases of malignancy. They included pancreatic cancer (n=2), colonic cancer (n=2), primary lung cancer(n=2), ovarian cancer (n=1), gastric cancer(n=1), and metastatic lung cancer (n=1). The cause of overlook was classified as follows : 1) too small lesions of malignancy to detect (n=2), 2) weak symptoms of malignancy masked by other common symptoms (n=6), and 3) insufficient differential diagnosis due to poor doctor-patient-relationship (n=1). Conclusion: We may see patients with malignancy among the patients who were referred to psychosomatic medicine. So it is important to be careful in seeing the patients with medically unexplained symptoms, in whom malignancy might be hidden.

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